Ben-Izhak O, Stark P, Levy R, Bergman R, Lichtig C
Department of Pathology, Rambam Medical Center, Haifa, Israel.
Am J Dermatopathol. 1994 Jun;16(3):241-6. doi: 10.1097/00000372-199406000-00003.
In order to determine epithelial markers in malignant melanoma in routinely processed paraffin sections and to compare the staining of primary (cutaneous) malignant melanomas and their metastases, we stained formalin-fixed paraffin sections of 13 primary and 18 metastatic malignant melanomas using the streptavidin-biotin peroxidase method by antibodies to S-100, vimentin, HMB-45, polyclonal carcinoembryonic antigen (CEA), monoclonal CEA, cytokeratins (CAM 5.2 and broad-spectrum CKKES), and epithelial membrane antigen (EMA). All primary and most metastatic malignant melanomas showed positive staining with anti-S-100, HMB-45, and anti-vimentin. Reactivity with polyclonal CEA was observed in 15 (48%) of the 31 lesions; 14 of them were metastatic. No lesion was reactive with monoclonal CEA. Significant cytokeratin (CK) staining was evident in only three (9.7%) lesions (all metastatic), which also stained specifically with anti-CK 18. EMA was observed only focally in two (6.5%) lesions. There was no correlation between epithelial markers staining of the primary tumours and their metastases. All lesions with CK or EMA staining showed concomitant extensive staining for S-100, HMB-45, and vimentin. We conclude that (a) polyclonal CEA staining in malignant melanoma is not rare and is probably due to CEA-related molecules; (b) significant CK reactivity is rare and related to simple CK, such as CK 18; (c) epithelial marker reactivity is more common in metastases of malignant melanomas and is not correlated to the reactivity in their primary tumors. Considering our results and reports of positive S-100, vimentin, and HMB-45 in epithelial tumors, a wide panel of antibodies is recommended for the study of undifferentiated tumors.
为了在常规处理的石蜡切片中确定恶性黑色素瘤的上皮标志物，并比较原发性（皮肤）恶性黑色素瘤及其转移灶的染色情况，我们采用链霉亲和素-生物素过氧化物酶法，用抗S-100、波形蛋白、HMB-45、多克隆癌胚抗原（CEA）、单克隆CEA、细胞角蛋白（CAM 5.2和广谱CKKES）以及上皮膜抗原（EMA）的抗体，对13例原发性和18例转移性恶性黑色素瘤的福尔马林固定石蜡切片进行染色。所有原发性和大多数转移性恶性黑色素瘤对抗S-100、HMB-45和抗波形蛋白呈阳性染色。在31个病变中的15个（48%）观察到与多克隆CEA的反应性；其中14个为转移灶。没有病变与单克隆CEA反应。仅在3个（9.7%）病变（均为转移灶）中观察到明显的细胞角蛋白（CK）染色，这些病变也与抗CK 18特异性染色。仅在2个（6.5%）病变中局灶性观察到EMA。原发性肿瘤与其转移灶的上皮标志物染色之间没有相关性。所有有CK或EMA染色的病变同时对S-100、HMB-45和波形蛋白呈广泛染色。我们得出结论：（a）恶性黑色素瘤中的多克隆CEA染色并不罕见，可能是由于与CEA相关的分子；（b）明显的CK反应性罕见，且与简单的CK如CK 18相关；（c）上皮标志物反应性在恶性黑色素瘤转移灶中更常见，且与原发性肿瘤中的反应性无关。考虑到我们的结果以及上皮性肿瘤中S-100、波形蛋白和HMB-45阳性的报道，建议使用多种抗体来研究未分化肿瘤。
